The Essential Writings of Sabina Spielrein

Pioneer of Psychoanalysis

Sabina Spielrein, Ruth I. Cape, Raymond Burt, Ruth I. Cape, Raymond Burt

• Publisher: Routledge
• Year: 2018
• eBook ISBN: 9780429892721
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Sabina Spielrein's writings explore the burning topics in the early days of psychoanalysis while providing insight into the culture of the time and her own personal struggles. After a comprehensive historical and biographical introduction to Spielrein by John Launer, The Essential Writings of Sabina Spielrein: Pioneer of Psychoanalysis presents full-length English translations of her first three and most essential writings, offering deep insight into her brilliant and pioneering mind:

• The first unabridged English rendition of her medical dissertation of 1911, entitled "On the Psychological Content of a Case of Schizophrenia (Dementia Praecox)", with an afterword by Adrienne Harris
• A new, improved English translation of Spielrein's seminal essay of 1912, "Destruction as the Cause of Becoming"
• A faithful English rendition of her 1913 essay "Contributions to Understanding a Child's Mind"

The Essential Writings of Sabina Spielrein: Pioneer of Psychoanalysis presents a rich source of materials and inspiration to psychoanalysts, psychoanalytic psychotherapists and analytical psychologists, as well as scholars in the humanities and the behavioral sciences.

Chapter 1

On the Psychological Content of a Case of Schizophrenia (Dementia Praecox) (1911)

Introduction

In recent years, research studies¹ have led to an understanding of schizophrenia (dementia praecox) which, in various respects, is in need of a broader empirical foundation. It is my intention to investigate a case of paranoid dementia, initially without regard to the current scholarly opinions, but guided solely by the goal of obtaining a deeper insight into the psychic processes of this patient. I chose this case because the patient – as an intelligent and well-read woman – offers substantial material, which, at first glance, appears to be a confused mix of completely nonsensical sentences. I deem it best to present the material as completely as possible, that is, nearly word for word as communicated to me by the patient, so that the reader has the opportunity to verify whether my conclusions are justified. I would only ask the reader not to make assumptions about my conclusions based on the arbitrariness of any fragment: Having the entire analysis before my eyes, I found myself occasionally moving on ahead with an explanation. Nevertheless, the subsequent material will furnish the proof for the accuracy of the “interpretation.”

In many cases, my interpretations were confirmed in spontaneous statements by the patient. On other occasions, the patient was unable to provide straightforward answers to the questions, preferring rather to make vague statements that digressed into other topics which, in turn, one would have to decode, thereby risking getting lost in details. Furthermore, pushing for a certain explanation deprives us of the advantage of examining the unconstrained chain of associations as a whole. In addition, one would risk forcing the patient to reveal embarrassing facts, thus evoking feelings of displeasure about being examined. While following these considerations, I had to draw my conclusions mostly from her previous statements and the general context. In the beginning, I had to pay close attention to details in order to ensure the correctness of my conclusions. Later, however, for example in the chapter “Childhood impressions,” etc., when I was already quite familiar with the patient’s language, I chose not to trouble her with questions, but translated her words directly into our language. In order to avoid influencing the patient, I did not look at her medical history and anamnesis until I had basically finished the examination. Only then did I consider the extent to which my findings matched her medical history [clinical notes] and the description of her health history, and how my findings might be able to interpret the latter. It was not easy to follow the confused mix of her thoughts. For that reason, frequent repetitions seemed to me to be required at various points. Nevertheless, in order to test the correctness of my conclusions, one must proceed like an investigating judge and familiarize oneself with the case meticulously, to the extent that one virtually empathizes with every word.

Anamnesis (from the medical history)

The husband gives the following report:

He has known the patient for eleven years. He does not know of childhood illnesses she might have had. She was always healthy, and he also did not notice any mental abnormalities. While in school, she was intelligent and had many interests, particularly in literature. She has always shown religious tendencies. Thirteen years ago, they married. In their sexual relationship she was frigid. Soon after getting married, she became pregnant. The pregnancy proceeded normally, the birth went well, and so did the days following the delivery. Her child once almost swallowed a small ball. This terrified her so much that she was agitated for several days. Six years ago, she became pregnant again. At that time, she had quite an upsetting experience: The doctor told her that her mother was suffering from cancer of the esophagus. As a result, the patient had seizures during which she believed she was dying and thought her heart stopped beating. The attacks lasted from half an hour to an hour. Often, she calmed down the moment a doctor arrived. She had no appetite and, apparently, already had stomach problems. The birth was a difficult forceps delivery. When they started the anesthesia, ether ran down her face and burnt her eyes. This experience continued to haunt her for a long time. When, two years later, her mother died, she handled her death well. In spring of 1903, she had a spontaneous abortion (in about the seventh month). After a dilation and curettage procedure, she ran a fever and was quite weak. For three weeks, she was hospitalized. While there, she was sedated a third time. While being under anesthetic, she apparently had horrible dreams about which she later recounted ceaselessly. (The reporting person [her husband] does not know any details about it!). When she returned home, she showed, as in previous times, a strong desire for love which, however, appeared to the reporting person as exaggerated and pretentious. Furthermore, she displayed a great urge to work, but was often quite tired. In the summer before her illness, she enjoyed a happy vacation. The patient was exuberant. Afterwards, however, she felt drained and believed she was pregnant again, although she was not. Since fall of 1905, she has passionately cared for a poor family and always showed effusive joy when something for the poor was sent to her. On November 16, when a deaconess came to visit her, she was noticeably quite anxious and prayed with her. At night, she woke her husband and told him he was not religious enough. On November 17, her behavior was calm and normal. The patient runs an embroidery business. Once she had kept a piece of fabric from a dress that had been delivered. She wrote the woman in question that she had kept some of the fabric (of which too much had been sent to her), and she felt guilty because of this. In the evening, she again criticized her husband over religion and said she would not be quiet until her husband and his family had also found salvation. On the morning of November 18, she was euphoric. In the afternoon, she cried and suddenly made a big scene because, in her eyes, her husband did not have the right belief. She alleged that her sister was sick and had to go to bed, considered herself dirty, and claimed she was not allowed to go to bed. From then on, she continually spoke in a chaotic jumble and alleged that everyone was dirty, that everyone had to wash their hands, and that her feet needed to be washed. Then she prayed again. She continued in this way until she was admitted to the hospital.

That was all we learned from her husband. It was impossible to come up with a consistent anamnesis by talking with the patient herself because, as her husband attests, her words were “a chaotic jumble.” Let us now look at the further progress of her illness. I will mention only as much from her medical history as is necessary for understanding the chapter in question. For that reason, I should mention here that the patient is a Protestant, her husband a Catholic. She mentions several times that her husband, a professor by profession, was seduced by two of his female students. One student in particular, a beautiful rich girl, was to blame. She refers to this girl as That Woman [Frauenzimmer].

The present state (status praesens)

The patient looks a little pale and tired; otherwise – no noticeable physical disabilities.

Sense of orientation – for time and location – good.

Mental retention and memory – not disturbed.

Affectivity – inadequate. The patient appears like a bad actress who cannot share her feelings with the outside world and, in order to compensate for that inability, acts in an excessively emotive way. The pathos of the patient seems somewhat forced. Her facial expressions range from masklike to serious to empty; at other times she seems to smile to herself. The sound of her voice shows little modulation. Its pathos seems empty and basically “without affect.”

Her language – is highly confused, sometimes interspersed with an absurd play on words. She frequently shuts down and holds back thoughts.

Hallucinations – primarily of her face, her hearing (voices), and her physical feelings, for example, of becoming electrified.

Delusions – highly absurd. For example, she thinks she is being “catholicized,” contaminated with urine, “beaten through Basel,” is anesthetized and then wakes up as a horse, is a little Forel, is “dissected,” “phrenologized,” “mythologically treated,” etc.

Mannerism – Sometimes she lies “on her stomach,” at other times, she falls on her knees before God and in a solemn voice whispers words to herself; in general, few characteristic manners.

Psychomotor abnormalities – like catatonia – almost altogether absent; no consistent negativity, no catalepsy; echolalia, echopraxia – absent; no stereotypical demeanor or perseverations.

Usually stays in the ward for the restless, is occasionally quite violent.

Diagnosis: A paranoid form of dementia praecox.

1. Catholicization

We learn from the medical history that the patient did not love her husband in a sexual sense and had many fights with him. She claims that he had preferred one of his students over her. Her husband is a Catholic, the patient a Protestant. The patient often mentions that she was being “catholicized” here in the institution.

Question:

“What do you mean by catholicizing?”

Answer:

“Michelangelo, Sistine art, and the Madonna have to do with art history. The Madonna has come into contact with Lao art; this has to do with Laocoön. Sistine art is sexual art. Derived from Sistine art is Lao art or generation art. Sistine art can elicit sexual art: By looking at a beautiful image, one can turn into poetry and perhaps forget one’s duty. Sistine poetry is the poetry of the Catholics and must have to do with the Madonna, Raphael, and the whole poetry of Catholics.”

This is what the patient said. Everyone is familiar with the Sistine Chapel in Rome, a Catholic place of worship that also houses the frescoes of Michelangelo. Another part of the Catholic worship is the Madonna, whose beauty is adored by the whole world. One Madonna by Raphael is, as is well known, called the Sistine Madonna. “The Sistine art” (Chapel), or rather Catholic religion (= art = “poetry”), is associated with beauty (Madonna, Raphael, Michelangelo). From the Sistine art, sexual art is derived: “By looking at a beautiful image, one can turn into poetry and perhaps forget one’s duty,” says the patient. The phrase “forget one’s duty” out of a wife’s mouth openly reveals the erotic element of “poetry,” so that we may equate “poetry” with “in love.” In fact, the patient claims that her husband lets himself be blinded by beauty and thereby forgets his duties towards his wife and children. Without being asked further questions, sh...

Table of contents

• Cover Page
• The Essential Writings of Sabina Spielrein
• Title
• Copyright
• Dedication
• Contents
• Acknowledgments
• Preface
• Introduction by John Launer
• 1 On the Psychological Content of a Case of Schizophrenia (Dementia Praecox) (1911)
• Afterword by Adrienne E. Harris, Phd
• 2 Destruction as the Cause of Becoming (1912)
• 3 Contributions to Understanding a Child’s Mind (1913)
• Bibliography
• Index